The effect of metformin and myoinositol on metabolic outcomes in women with polycystic ovary syndrome: role of body mass and adiponectin in a randomized controlled trial

Soldat-Stanković, Valentina; Popović-Pejičić, Snježana; Stankovic, Sinisa; Prtina, Alma; Malesevic, Gabrijela; Bjekić-Macut, Jelica; Livadas, Sarantis; Ognjanović, Sanja; Mastorakos, George; Micić, Dragan; Macut, Djuro

doi:10.1007/s40618-021-01691-5

Cited by 22 publications

(16 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In general, the treatment of the underlying reason of cytokine profile disruption is beneficial and may reverse the diseases' negative effects on fertilisation and pregnancy outcomes. A good example of this is PCOS, in which insulin resistance therapy, body weight reduction, and lifestyle changes, as well as pharmacological treatments, for example, metformin, can have a beneficial effect on the leptin levels and cytokine profile of patients [49][50][51].…”

Section: Practical Aspects and Unanswered Questionsmentioning

confidence: 99%

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo

et al. 2021

View full text Add to dashboard Cite

A balance within the immune system is necessary for the proper development of ovarian follicles. Numerous cytokines were detected in follicular fluid, the role of which in reproductive physiology seems crucial. They influence the development and maturation of the follicle, ovulation, and corpus luteum formation, as well as embryo implantation and maintenance of pregnancy. The analysis of follicular fluid requires its collection by puncturing of the ovary, which is usually executed in connection with various gynaecological procedures. When interpreting such test results, clinical indications for a given procedure and the method of patient preparation should be taken into account. This review revealed the results of currently available studies on the concentration of pro-inflammatory cytokines in follicular fluid in various forms of infertility. Additionally, it presented cytokines, whose concentration has a significant impact on the size of ovarian follicles, their number, the effectiveness of in vitro fertilisation, development of the embryo, and chances of correct implantation. Despite the many recent publications, the knowledge of follicular fluid immunology in the context of reproductive pathology is superficial and further research is required to extensively understand the roles of individual cytokines in reproductive pathology. In the future, this knowledge may enable patients’ individual qualifications to individual methods of infertility treatment, as well as the possible adjustment of the treatment regimen to the patient’s immune profile.

show abstract

Section: Practical Aspects and Unanswered Questionsmentioning

confidence: 99%

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Studies comparing metabolic effects of metformin and myo-inositol included only or mainly women with polycystic ovary syndrome and provided incongruent results. 25,26 However, at the beginning of the current study, glucose homeostasis markers did not differ between the study groups and therefore differences in insulin-sensitizing potencies of metformin and myo-inositol cannot explain our findings. They cannot be also related to the effect on levothyroxine absorption, which has not been affected by concomitant metformin ingestion.…”

Section: Discussionmentioning

confidence: 53%

“…This clearly suggests the existence of an association between hormonal, immunosuppressive and metabolic effects of both treatment options. Studies comparing metabolic effects of metformin and myo‐inositol included only or mainly women with polycystic ovary syndrome and provided incongruent results 25,26 . However, at the beginning of the current study, glucose homeostasis markers did not differ between the study groups and therefore differences in insulin‐sensitizing potencies of metformin and myo‐inositol cannot explain our findings.…”

Section: Discussionmentioning

confidence: 58%

Differences in levothyroxine action on thyroid autoimmunity and hypothalamic–pituitary–thyroid axis activity between metformin‐ and myo‐inositol‐treated women with autoimmune subclinical hypothyroidism

Krysiak

Kowalcze

2022

Clinical Pharmacy Therapeu

View full text Add to dashboard Cite

What is known and objective: Insulin resistance impairs the impact of levothyroxine on thyroid autoimmunity and hypothalamic-pituitary-thyroid axis activity. Both metformin and myo-inositol were found to improve insulin sensitivity and to reduce thyrotropin levels in individuals with hypothyroidism. The aim of the present study was to compare the effect of levothyroxine on thyroid autoimmunity and hypothalamicpituitary-thyroid axis activity between women receiving metformin and myoinositol. Methods:The study included two groups of women with autoimmune hypothyroidism, treated for at least 6 months with either metformin (group A; n = 25) or myo-inositol (group B; n = 25). Both groups were matched for age, insulin sensitivity, hormone levels and antibody titers. For the following 6 months, all women received levothyroxine. Plasma levels of glucose, insulin, thyrotropin, free thyroid hormones,

show abstract

“…Therefore, alternative treatment with fewer side effects would be beneficial in managing these patients. In recent years, several studies have analyzed the potential effects of inositol supplementation, suggesting that inositols are potent alternatives for metformin in treating PCOS [ 12 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials

Greff

Juhász

Váncsa

et al. 2023

Reprod Biol Endocrinol

View full text Add to dashboard Cite

Background Metformin is the gold standard insulin sensitizer, which is widely used to treat insulin resistance in polycystic ovary syndrome (PCOS). However, metformin may induce gastrointestinal side effects. Objective Inositols have long been debated as a potential alternative for metformin in treating PCOS. Therefore, the present systematic review aimed to evaluate the efficacy and safety of inositols in treating PCOS. Methods The present systematic search was performed in CENTRAL, MEDLINE, and Embase from the inception until October 20th, 2021. Eligible randomized controlled trials (RCTs) included women diagnosed with PCOS and compared any inositols with metformin or placebo. Our primary outcome was cycle normalization, whereas secondary outcomes were body mass index (BMI), parameters of carbohydrate metabolism and clinical and laboratory hyperandrogenism. Results are reported as risk ratios or mean differences (MDs) with 95% confidence intervals (CIs). Results Twenty-six RCTs were identified, including data of 1691 patients (806 inositol, 311 with placebo, and 509 metformin groups). In patients treated with inositols, the risk (CI: 1.13; 2.85) of having a regular menstrual cycle was found by 1.79 higher than in the case of placebo. Moreover, the inositols showed non-inferiority compared to metformin in this outcome. In the case of BMI (MD = -0.45; CI: -0.89; -0.02), free testosterone (MD = -0,41, CI: -0.69; -0.13), total testosterone (MD = -20.39, CI: -40.12; -0.66), androstenedione (MD = -0.69, CI: -1,16; -0.22), glucose (MD = -3.14; CI: -5.75; -0.54) levels and AUC insulin (MD = -2081.05, CI: -2745.32; -1416.78) inositol treatment induced greater decrease compared to placebo. Inositol increased sex-hormone-binding globulin significantly compared to placebo (MD = 32.06, CI:1.27; 62.85). Conclusion Inositol is an effective and safe treatment in PCOS. Moreover, inositols showed non-inferiority in most outcomes compared to the gold standard treatment; metformin. Trial registration PROSPERO registration number: CRD42021283275.

show abstract

The effect of metformin and myoinositol on metabolic outcomes in women with polycystic ovary syndrome: role of body mass and adiponectin in a randomized controlled trial

Cited by 22 publications

References 53 publications

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo

Function of Follicular Cytokines: Roles Played during Maturation, Development and Implantation of Embryo

Differences in levothyroxine action on thyroid autoimmunity and hypothalamic–pituitary–thyroid axis activity between metformin‐ and myo‐inositol‐treated women with autoimmune subclinical hypothyroidism

Inositol is an effective and safe treatment in polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials

Contact Info

Product

Resources

About